This is the place for general questions about drugs, long-term treatment concerns, possible influences of other drugs (such as antibiotics, heartworm preventatives, or anesthetics) for epileptic dogs, and other concerns. Please note that we cannot make specific recommendations for individual dogs - for this, please consult your veterinarian.

My dog has been on phenobarbital (30mg twice/day), keppra ER (500mg twice/day) and prednisone (5mg twice/day) for about 2 months and has been seizure free. He has had extreme muscle wasting in his hind legs (he can no longer jump or stand up on his back legs) and in his face and head where his skull bones are really protruding. His neurologist suggested I try reducing his prednisone because long term use can cause muscle wasting. I reduced it by 2.5mg/day (5mg in the AM and 2.5mg in the PM) eleven days ago and he seemed to be tolerating it well. No change in his behavior and no seizures.

Last night, about two hours after he had all his meds, he had a grand mal seizure lasting about 3 min. He continued to seize of the next two hours and by the 5th one, I took him to the ER. He seized a 6th time before they could get an IV in him. His temperature was 105.9. He has never been this bad off. The seizures stopped after getting IV Valium and phenobarbital and mannitol. They suggested I euthanize him or keep him in the ICU for 1-2 days on a Valium drip.

My questions are the following:
1. Could a reduction in prednisone by 2.5mg/day eleven days earlier cause the cluster seizures?
2. Is this something that will occur again even if I put him back on the 5mg prednisone twice/day and his seizure meds?
3. Could the seizing have come from the "honeymoon effect" of keppra? He has been on it for two months so could it not be working anymore?
4. Why do some dogs cluster rather than having one seizure at a time?
5. Now that he clustered, will he have a tendency to always have cluster seizures rather then just one?
6. Is there any way to know if he will seize like this again and how soon? He had been seizure free for 2 months and now I am afraid to have him out of my sight. The ER doctor said he could have died if he kept seizing.

Is it possible to speak with your neurologist again?
I wish I could answer definitively to your questions but unfortunately the only definite thing about epilepsy is that controlling seizures is a shot in the dark. Many dogs get control while others never do and there's really no reason why it works for some and not all of them. Every dog responds differently. You didn't mention why he's on prednisone. Is that for a secondary problem?
Keppra can have a Honeymoon period. We had it with Jake and had to adjust his mgs several times over his life. It's possible that since he clustered he'll be prone to them. It can be so scary to let them out of your sight when that happens. They can give you rectal Valium or Clorazepate to take home in case this happens again. They're also using injectable Keppra as a cluster buster.
I know this isn't much help.
I'm sorry you're going through this. Let us know how you are.

My dog has recently started having 2 seizures in one day. His come about every 3 months, and the last two times, he has had 2, around 6 hours apart. He is on no meds, he is 14. The 2nd seizure seems more intense than the first. Always scared it'll happen when I am at work and he'll fall off the dog ramp we built for him. He is SO off balance when this happens. It's really hard -